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Large Gaps In Health Perceptions V. Reality

Tristan Lejeune

Anew survey from Aon Hewitt, the National Business Group on Health and The Futures Company indicates that many American workers and their families - even those who know what it takes to get and stay healthy - have inaccurate perceptions about their own weight, condition and the cost of their health care. The survey results further indicate satisfaction with, and claims of positive behavior changes associated with, participation in consumer-driven health plans.

More than 2,800 employees and their dependents covered by employer-sponsored health plans were surveyed about their thoughts, attitudes and behaviors toward health and wellness.

Eighty-seven percent of respondents reported being in good health, yet more than half of those (53%) gave height and weight combinations that categorize them as having a body mass index in the overweight or obese categories. Only 23% of all respondents believe they are actually overweight or obese, when in reality that number is 34%.

"Employees want to be healthy, but many have an overly rosy perception of their health and may not see an urgent need to take action," says
Joann Hall Swenson, Aon Hewitt's health engagement leader. "For others, the activities and stresses of daily life take priority over good health, and many consumers are unwilling to make sacrifices to improve their health."

She says employers need to offer workers and their families "the necessary tools and resources that give them a realistic picture of their health," then follow up by encouraging healthy decision-making.

Incorrect cost perceptions

Consumers' incorrect perceptions extend to cost, the survey finds. Total health care costs per employee were $10,522 last year, according to an analysis, of which employers paid $8,318. When asked, however, how much of their bill their employer pays, the average respondent guessed around half that amount.

"These survey results," says
Helen Darling, president and CEO of the National Business Group on Health, "underscore the challenges employers face as they seek to engage employees and their families in health improvement as a means to better managing rising health care costs. It is critical for employers to bridge the knowledge gap evident in this survey."

It seems one way to do that is by offering a consumer-driven health plan, the survey reveals, as 60% of those in a CDHP say they have made positive behavior changes in regard to their health, including more preventive care (28%), seeking lower-cost options (23%) and more frequent research of health costs (19%).

In addition, 63% of respondents say they would complete a health risk questionnaire for a monetary reward, and just under that would engage in a healthy eating or weight management program.

"Consumers are looking for solutions that address their specific health needs and concerns," says
Christine Baskin, senior vice president at the Futures Company. "Tailored, targeted feedback such as that given in the HRQ process, along with understanding individual consumer's attitudes towards health, are essential ingredients to having employees take actions to improve their health and their lifestyle."

Satisfied with benefits

A separate survey, meanwhile, suggests that should the U.S. tax health benefits, workers will look elsewhere. More than half of U.S. workers would either drop coverage or shop around for a less costly plan should the government tax health benefits, according to research from the Employee Benefit Research Institute. However, nearly four-in-10 (39%) would stay with their current plan and level of coverage, up 10 percentage points over the past year.

The EBRI/MGA Health Confidence Survey reports that, should Congress make employment-based health coverage of U.S. workers taxable as a way to raise revenue and tame the federal deficit, 26% of wage earners would want to switch to a less expensive plan. Another 21% of respondents say they would try to get coverage directly from insurers, and 9% say they would want to drop coverage altogether.

Health coverage most important benefit

Many employers are uncertain whether and how they'll be able to offer health coverage as the Patient Protection and Affordable Care Act rolls into effect, but the most recent HCS finds that health insurance remains by far the most important employee benefit to workers.

"Most Americans are satisfied with the health benefits they have now and prefer not to change the mix of benefits and wages," says
Paul Fronstin, director of EBRI's health research and education program, and author of the report. "About three-quarters say they are satisfied with the health benefits they currently receive, while 15% say they would trade wages to get more health benefits, and 9% say they would surrender health benefits for higher wages."

Some 38% of those surveyed would prefer to continue getting coverage as they do today. One-third (34%) prefer to choose their insurance plan, have their employer give them the money that was being spent on their behalf and then pay the rest themselves; 23% would prefer that their company give them the money and allow them to decide whether to purchase coverage and how much to spend.

Most workers expressed confidence that their employers or unions have chosen the best health plan available, though many would like more choices. Respondents were not as confident, however, about choosing the best available plan if unions or employers did indeed cease offering coverage.